Community Mental Health Jeffrey Longhofer, Ph.D., PsyA., LCSW

Deinstitutionalization and Community Mental Health

The Community Mental Health Movement

Links to Resources on the Peer Consumer Movement
National Coalition for Mental Health Reform
Peer Consumer Movement
National Empowerment Center
WRAP

The Deinstitutionalization Movement

The Victorian lunatic asylum has a special place in history. Dreaded and reviled by many, these nineteenth-century buildings provide a unique window on how the Victorians housed and treated the mentally ill. Despite initially good intentions, they became warehouses for society's outcasts at a time when cures were far fewer than hoped for. Isolated, hidden in the countryside and surrounded by high walls, they were eventually distributed throughout Britain, the Empire, the Continent and North America, with 120 or so in England and Wales alone. Now the memory of them is fading, and many of the buildings have gone or are threatened. Most have been closed as hospitals since the 1980s and either been demolished or turned into prestigious private apartments, their original use largely forgotten. Their memory deserves rehabilitation as a fascinating part of Victorian life that survived into modern times. In The Victorian Asylum, Sarah Rutherford gives an insight into their history, their often imposing architecture, and their later decline, and brings to life these haunting buildings, some of which still survive today.
Biography
Sarah Rutherford is a Kew-trained horticulturist who obtained an MA in the conservation of historic parks and gardens at York University. She later worked for English Heritage assessing sites across England for the Register of Historic Parks and Gardens, becoming Head of the Register. During this time she researched and completed her doctoral thesis on the landscapes of nineteenth-century lunatic asylums and visited many before they were closed and redeveloped. She is now an enthusiastic freelance consultant researching and writing conservation plans for parks and gardens.

Benjamin Reiss. University of Chicago Press. 2008. In the mid-1800s, a utopian movement to rehabilitate the insane resulted in a wave of publicly funded asylums—many of which became unexpected centers of cultural activity. Housed in magnificent structures with lush grounds, patients participated in theatrical programs, debating societies, literary journals, schools, and religious services. Theaters of Madness explores both the culture these rich offerings fomented and the asylum’s place in the fabric of nineteenth-century life, reanimating a time when the treatment of the insane was a central topic in debates over democracy, freedom, and modernity.

Benjamin Reiss explores the creative lives of patients and the cultural demands of their doctors. Their frequently clashing views turned practically all of American culture—from blackface minstrel shows to the works of William Shakespeare—into a battlefield in the war on insanity. Reiss also shows how asylums touched the lives and shaped the writing of key figures, such as Emerson and Poe, who viewed the system alternately as the fulfillment of a democratic ideal and as a kind of medical enslavement. Without neglecting this troubling contradiction, Theaters of Madness prompts us to reflect on what our society can learn from a generation that urgently and creatively tried to solve the problem of mental illness.

“The Lives They Left Behind is a deeply moving testament to the human side of mental illness, and of the narrow margin which so often separates the sane from the mad. It is a remarkable portrait, too, of the life of a psychiatric asylum—the sort of community in which, for better and for worse, hundreds of thousands of people lived out their lives. Darby Penney and Peter Stastny's careful historical (almost archaeological) and biographical reconstructions give us unique insight into these lives which would otherwise be lost and, indeed, unimaginable to the rest of us.”—Oliver Sacks, M.D., Professor of Neurology and Psychiatry, Columbia University Medical Center, Columbia University Artist, and author of Musicophilia
“The haunting thing about the suitcase owners is that it’s so easy to identify with them.”—Newsweek
“In their poignant detail the items helped rescue these individuals from the dark sprawl of anonymity.”—The New York Times
“[The authors] spent 10 years piecing together . . . the lives these patients lived before they were nightmarishly stripped of their identities.”—Newsday
More than four hundred abandoned suitcases filled with patients’ belongings were found when Willard Psychiatric Center closed in 1995 after 125 years of operation. They are skillfully examined here and compared to the written record to create a moving—and devastating—group portrait of twentieth-century American psychiatric care.

Elaborately conceived, grandly constructed insane asylums—ranging in appearance from classical temples to Gothic castles—were once a common sight looming on the outskirts of American towns and cities. Many of these buildings were razed long ago, and those that remain stand as grim reminders of an often cruel system. For much of the nineteenth century, however, these asylums epitomized the widely held belief among doctors and social reformers that insanity was a curable disease and that environment—architecture in particular—was the most effective means of treatment.

In The Architecture of Madness, Carla Yanni tells a compelling story of therapeutic design, from America’s earliest purpose—built institutions for the insane to the asylum construction frenzy in the second half of the century. At the center of Yanni’s inquiry is Dr. Thomas Kirkbride, a Pennsylvania-born Quaker, who in the 1840s devised a novel way to house the mentally diseased that emphasized segregation by severity of illness, ease of treatment and surveillance, and ventilation. After the Civil War, American architects designed Kirkbride-plan hospitals across the country.

Before the end of the century, interest in the Kirkbride plan had begun to decline. Many of the asylums had deteriorated into human warehouses, strengthening arguments against the monolithic structures advocated by Kirkbride. At the same time, the medical profession began embracing a more neurological approach to mental disease that considered architecture as largely irrelevant to its treatment.

Generously illustrated, The Architectureof Madness is a fresh and original look at the American medical establishment’s century-long preoccupation with therapeutic architecture as a way to cure social ills.

Carla Yanni is associate professor of art history at Rutgers University and the author of Nature’s Museums: Victorian Science and the Architecture of Display.

An entertaining and poignant social history of McLean Hospital—temporary home to many of the troubled geniuses of our age—and of the evolution of the treatment of mental illness from the early 19th century to today

Entertainment Weekly
[Beam] elicits fascinating stories from both residents and staff...[and]...has nicely traced the history of this institution and its inhabitants.
More Reviews and Recommendations

Biography

Alex Beam is a columnist for the Boston Globe and the author of two novels. He has also written for the Atlantic Monthly, Slate and Forbes/FYI. He lives in Newton, Massachusetts with his wife and three sons.